Sustaining and Increasing the Benefits of Public Health

Department of Public Health SymbolUpdated October 2014

Public health is the practice of preventing disease and promoting good health within groups of people, from small communities to entire countries. In the current economic environment, public health seeks to improve its effectiveness and efficiency to produce a sustainable health system.

Public health professionals work to prevent population-wide health problems through educational programs, policies, services, regulation of health systems and some health professions, and research. In contrast, clinical professionals, such as doctors and nurses, focus primarily on treating individuals after they become sick or injured. The dramatic achievements of public health in the 20th century have improved our quality of life, increased life expectancy, reduced infant and child mortality, and eliminated or reduced many communicable diseases.

A strong public health infrastructure to prepare for and respond to both acute (emergency) and chronic (ongoing) threats, protects the nation's health. To become more coordinated, efficient and effective, public health must identify and sustain “core” services; increase adherence to national public health standards; coordinate among health departments and other sectors, especially health care; stabilize funding for basic infrastructure and core services; and explore shared services. An NCSL article, A Wealth of Public Health, discusses the public health system and the state legislative role.

A series of Institute of Medicine (IOM) reports from 2010 to 2012 highlight leverage points to improve the public health system and explore its integration with primary care to improve population health. In the April 2012 report For the Public's Health: Investing in a Healthier Future, the IOM identifies “essential ingredients” to renew the public health system:

  • Adequate and sustainable funding for governmental public health;
  • Reform of governmental public health infrastructure and operations to align spending with need; and
  • Using public health knowledge to help improve delivery and quality of clinical care and integrate it with public health’s population-based efforts.

Taking Steps: Public health organizations at the federal, state, tribal, local and territorial levels already are taking steps to increase effectiveness and efficiency. Through its National Public Health Improvement Initiative (NPHII), the Centers for Disease Control and Prevention supports improvements in 74 state, tribal, local, and territorial health departments’ systems, practices, and essential services. Early successes include:

  • New Jersey’s faster reporting time for influenza test results from 2–3 weeks to 2–3 days;
  • Tennessee’s strengthened public health data system for vital records; and
  • Virginia’s consolidation of critical data measures from 119 public health system databases into one real-time user interface serving all offices.

Voluntary Public Health Accreditation, another effort to improve quality and performance of public health departments, was launched in December 2011 supported by the Centers for Disease Control and Prevention and private funding. Their online resources are located at  Efforts to integrate public health and health care are also becoming more prevalent as public health offers assets such as information on community health status, delivers economical and effective prevention, delineates evidence-based practice guidelines and assists individuals in making healthy choices.

National Center for Health Statistics gathers and maintains a wide variety of health statistics, data sets and reports available for state policymakers and researchers alike. For more information, go to:

Creating Effective State Health Systems - Resources by Topic Area

Accountable Care/Coordinated Care

Budget/Other Resources

Community Benefit/Needs Assessment

Evidence-Based Practices

  • The Guide to Community Preventive Services (The Community Guide)  is a resource that assists users in choosing programs and policies to improve health and prevent disease in communities.
  • US Preventive Services Task Force (USPSTF) is an independent panel of non-Federal experts in prevention and evidence-based medicine and is composed of primary care providers (such as internists, pediatricians, family physicians, gynecologists/obstetricians, nurses, and health behavior specialists). The USPSTF conducts scientific evidence reviews of a broad range of clinical preventive health care services (such as screening, counseling, and preventive medications) and develops recommendations for primary care clinicians and health systems. These recommendations are published in the form of "Recommendation Statements."

Public Health Law Resources

Shared Services

Performance/Quality Improvement

Public Health and Clinical Care

Systems Change

  • National Prevention Strategy - NCSL LegisBrief, July 2012
  • National Prevention, Health Promotion and Public Health Council - The Council members are cabinet secretaries, chairs, directors, or administrators of federal departments. By including officials from across the federal government, the Council may benefit from a wide variety of perspectives and inter-agency collaboration. The Council is pursuing a more holistic approach to community health that address a number of factors that influence our health–housing, education, transportation, the availability of quality affordable food, and conditions in the workplace and the environment. Recently released is the National Prevention Council Action Plan Implementing the National Prevention Strategy, which outlines more than 200 prevention and wellness steps the federal government is taking to implement the National Prevention Strategy.
  • - A new digital meeting space sponsored by the Robert Wood Johnson Foundation to spark an ongoing conversation about public health challenges, opportunities, evidence, solutions and innovations. RWJF invites and encourages active participation.
  • For the Public's Health: Revitalizing Law and Policy to Meet New Challenges - The Institute of Medicine examined the legal and regulatory authority for public health activities, identified past efforts to develop model public health legislation, and described the implications of the changing social and policy context for public health laws and regulations. (IOM, June 21, 2011)
  • Transforming Public Health: Emerging Concepts for Decision-making in a Changing Public Health World - The Transforming Public Health project indicates the need for health departments to develop policy goals; use integrated data sets; communicate with the public and other audiences to disseminate and receive information; mobilize the community and forge partnerships; cultivate leadership along with organization, management, and business skills; and protect the public in the event of an emergency.
  • State Roles in Delivery System Reform - This report outlines the evidence in health system reforms, as well as the opportunities for governors to lead these efforts. With contributions from experts in the health care policy field, the report provides tools available to states to create a more efficient and effective health care system. (National Governors Association)
  •  A Healthier America 2013: Strategies to Move from Sick Care fo Health Care in Four Years, from Trust for America's Health.


A Wealth of Public Health State Legislatures Magazine, December 2013
Public Health Department Accreditation - LegisBrief, October 2013
Primary Care and Public Health Working Together - LegisBrief, August 2012
Sustaining and Increasing the Benefits of Public Health - Public Health Herald Newsletter, Aug. 2012
Average State Public Health Spending Per Person, FY 2010-2011 - Postcard, July 2012
National Prevention Strategy - LegisBrief, July 2012
Community Transformation Grants - Postcard, May 2012
Grants to Strengthen Public Health Programs, Infrastructure and Workforce - Affordable Care Act: State Action Newsletter, Sept. 2011

Article References
10 Essential Public Health Services - National Public Health Performance Standards Program (NPHPSP); CDC, Dec. 2010
American Public Health Association’s “What is Public Health? Our Commitment to Safe, Healthy Communities” - American Public Health Association, 2012
Association of Schools of Public Health’s “What is Public Health?” - Association of Schools of Public Health, 2012
Healthy People 2020 – Public Health Infrastructure Chapter- Healthy People 2020, Aug. 2012